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c/semaglutide·posted 1 year ago by u/source_or_silence

the weekly dosing thing finally clicked for me and I want to write it down

Discussion Sourced ×1 Slow Clap ×3 Long Haul ×3

the weekly dosing thing finally clicked for me and I want to write it down, which sounds obvious until you try to state the evidence for it.

The weekly interval comes out of the half-life — roughly a week — so you are on a smooth curve rather than a series of spikes. That is also why moving your day slightly does very little.

Delayed gastric emptying is most pronounced early and attenuates with continued dosing, which is why the constipation usually fades at a stable dose.

The mental model that finally made this click for me: there are two curves, and people watch the wrong one.

The first is exposure, which is set by the dose and smoothed by a week-long half-life. It changes when you change the dose and then settles over about a month. The second is body weight, which is exposure filtered through appetite, food, water, sleep, training and the scale itself, and which moves in steps rather than a line.

Almost every "it stopped working" post is somebody watching curve two over a fortnight and drawing conclusions about curve one. If the appetite effect is still there, exposure is fine. Wait the month.

Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.

5,801 up / 204 down97% upvoted35 commentsid 1btc2j10 Mar 2025

35 comments

13 in this archive, depth 5

best — the order this archive was captured in

u/micro_bump_mick659 points·1 year ago

The escalation schedule in the trials existed to keep people on the drug. It is a tolerability ramp, and it is why the label reads the way it does.

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u/source_or_silenceOP306 points·1 year ago

The appetite thing was the surprise. I expected to feel full. What I got was simply not thinking about food between meals.

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u/ahmed_okafor494 points·1 year ago·edited

That reads like a titration plan and this board cannot give you one. Somebody who actually knows your history has to.

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u/greta_lokken170 points·1 year ago

Same. I sat at 0.25mg for three months because it was working and there was nothing to fix.

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u/reflux_report305 points·1 year ago

Yes. Week 86 is when almost everybody writes the "is it still working" post, and almost everybody is fine.

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u/source_or_silenceOP445 points·1 year ago

the first four weeks are a tolerance check, not a weight-loss phase

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u/kavya_radich363 points·1 year ago

Small correction: 2.4mg is the maintenance ceiling on the label, not the starting maintenance dose. The distinction matters for anyone reading this later.

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u/adaeze_brandt498 points·1 year ago

the food noise going quiet is the effect people actually describe

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u/archived_thread_a149 points·1 year ago

Same injection day each week, or has it drifted?

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u/endpoint_creep-1 point·1 year ago

do not chase somebody else’s titration schedule, they are not you

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u/rina_bergstrom1 point·1 year ago

dose day drift of a day either way is fine, the curve barely notices

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u/plain_titration1 point·1 year ago

protein first, then everything else gets easier

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u/reflux_report1 point·1 year ago

Disagree. 2.4 is the top of the label, not the goal, and "everyone ends up there" is just survivorship in the posts you read.

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